Sometimes people don’t believe I’m particularly sick. They meet me, I look fine, I interact, I charm, I wit and all seems, if not normal, at least something reasonably normal adjacent. And that’s fine. It’s by design. Being a high-functioning mentally ill person, I can’t really afford to run around with my hair on fire. But faking normalcy, happiness and pleasure is a tricky and very expensive bit of business.

Congratulations; if you’re reading this you’ve survived the holidays, or most of them anyway. You’re past the late-night wrapping sessions, the overindulgence in eggnog and the stuffing that you never like but every year are forced into eating anyway. Huzah. But if you’re a bipolar like me, you’ve found that all that forced merriment has left you feeling hollow, tired and depressed, so it’s time to take action to get back to your pre-holiday self.

I’m spending this Christmas back in the town where I grew up, sleeping in my mother’s guest room. I have to be there a week. A week with parents and siblings. A week of turkey and tiny oranges. A week of me silently begging to go home. But I understand that holiday obligations are, well, obligatory, so I do have some methods for trying to survive it.

OK, so I admit it, I haven’t spent a whole lot of time thinking about gender’s relationship to depression. I know the basic pieces of information: more women are diagnosed with depression than men, and more women attempt suicide while more men actually commit suicide. But there is a lot to understand beyond that. Did you know that men are up to 15 times more likely to commit suicide than women?

I have been through very long, dark nights of the psyche. I have been in pain I didn’t think I could survive. I’ve been in pain I almost didn’t survive. I have done things I never wanted to do. I have done things I never thought I would do. I have been to places most people wouldn’t even come up with in their nightmares. And when I’m not there, I’m grateful. No matter how much I might think things suck, I’m not sitting in that particular pile of blood and muck. No matter how I feel today I can honestly say it can get worse. Every time I think I’ve hit bottom I’ve found there is actually more bottom beyond that. It is unfortunate but true, there is no maximum to pain. And any time I even think about changing meds I’m worried I will go there again.

What I know about the brain is a fragment of what is known about the brain. What we know about the brain is a fragment of what there is to know about the brain. That being said, what we do know is worth taking a look at. In the 1960’s scientists discovered that increasing levels of dopamine, norepinephrine, and serotonin in the brain reduced depressive symptoms. This suggested that a depressed brain didn’t have enough of these chemicals and this is where the chemical imbalance theory came from. It was quite reasonable and made perfect sense, but we’ve learned a lot since the 1960s.

I am a word-fetishist. I adore words. They are my playthings. They are my blankies. I generally mold them, shape them and occasionally break them at my leisure. But I also respect words. I respect their meaning and their use outside the bounds of current politically correct, self-help thinking, but somehow the rest of the world wants to complain because I call a spade a shovel.

I have been through more bipolar treatments than I care to recall; probably everything you’ve heard of plus a bunch of bipolar treatments you haven’t. And yes, obviously, I have failed the vast majority of these bipolar treatments. And while not getting better is certainly nasty enough, it always feels like it’s my fault that the treatment didn’t work.

Over the years I’ve been treated for bipolar, I’ve come to the conclusion that when you sleep and when you wake (your circadian rhythm) is key in stability and wellness. If you do not wake up at the same time every morning and go to bed at the same time every night you are in for a world of hurt. This is mostly my opinion though. There is some research on the matter, but nothing as conclusive as I feel about it. Or at least nothing that I knew about until I heard of the Chicago Psychiatry Associates’ Program in Psychiatric Chronotherapy. (Sounds complicated, but it isn’t. Stay with me.)

Many of us with a mental illness have tried to “power through” it. We have tried to muscle through the pain without getting help of any kind. Most of us don’t want to admit we need help. Most of us don’t even want to admit we’re sick. We think that we’ll be fine without doctors and therapists and pills. We think that they are the enemy. We think we’re better off without them. We are so ridiculously wrong.